The present invention generally relates to irrigation/aspiration apparatus for surgical procedures and more particularly relates to fluid management apparatus for use with a surgical instrument for endophthalmic surgery.
The removal of cataracts, for example, involves surgery on a normally pressurized eye in which instruments are passed through a small incision at the edge of the cornea in order to access and remove opaque cataract material.
The cataracts may be fragmentized by cutting apparatus, vibratory apparatus, or the like, and the fragments are aspirated from the eye.
In order to maintain normal pressure within the eye, a balanced saline solution is supplied from an elevated chamber, the chamber being elevated to a position to provide proper head, or pressure.
The irrigation and aspiration of fluid through the eye must be carefully monitored and controlled in order to maintain normal pressure within the eye during surgical procedures. An under-pressure may cause distortion of the eye which often may interfere with surgical procedures. Over pressure may cause damage to the eye and in extreme cases, rupture thereof.
As it has been hereinabove noted, pressure in the eye may be controlled by the physical elevation of the chamber of balanced saline solution, which is connected to the surgical instrument. Aspiration fluid, on the other hand, is typically controlled in the eye with a peristaltic pump or the like.
Conventional apparatus includes an instrument console for controlling the flow of fluids. Various devices have been developed for the coordinated flow of fluids and some include a phacocassette, or tubing and management system, which may be disposable or autoclavable, for interconnecting from the various tubes and lines for proper irrigation and aspiration.
A general discussion of the advantages of this type of cassette is set forth in U.S. Pat. No. 4,713,051, which teaches a housing for supporting a portion of irrigation and aspiration tubing, together with a drain bag structured so that all fluid and connections are precisely made to a console by insertion of the cassette thereinto. Thus, the reliability of the fluid connections is enhanced.
Other fluid management apparatus for control of irrigation and aspiration fluid as well as cassettes therefore are discussed in U.S. Pat. Nos. 4,424,116; 4,475,904; 4,479,761; 4,627,833; 4,735,610; 4,798,580; 4,904,168; 4,963,131; 5,106,366; 5,470,312 and 6,059,765.
The last hereinabove referenced namely, U.S. Pat. No. 5,470,312, teaches a chamber and diaphragm arrangement for improving response time to pressure variations in an aspiration line while a surgical instrument and is incorporated herewith entirely by this specific reference thereto.
A chronic problem with the use of hereinbefore tubing management systems, or cassettes, is the maintenance of tubing displaced in the cassettes. Slots or openings generally provided in the cassette aligned tubing therewithin for access by plungers and the like when installed on a console, the plungers being actuated to effect flow control through the tubing in the cassette. Proper alignment must be maintained in order that fluidflow through the tubing can be precisely controlled. Unfortunately, handling of the cassette or manifold, in combination with applied pressure to the tube to control flow therethrough has a tendency to dislodge or misalign the tubing within the manifold.
The present invention provides for a tubing management manifold which includes tubing captures to insure tubing placement within the manifold and prevent unwanted dislodgment or misalignment of the tubing from and within the manifold.
A tubing management manifold in accordance with the present invention for surgical instrument console for controlling fluidflow to and from a surgical instrument generally includes a housing having a front and opposing sides. Openings disposed, in each of the opposing sides are provided for enabling the tubing to be disposed between and across the opposing sides.
Ports disposed in the housing front enable access to the tubing disposed across the housing in order to control fluidflow through the tubing. This occurs when the tubing management manifold is installed in a corresponding console having solenoids or actuators for contacting and compressing the tubing through the ports.
A tubing capture is disposed on one of the opposing sides and aligned with one of the openings is provided for grasping the tubing in order to prevent unwanted dislodgement of the tubing from the housing. Preferably, the capture extend outwardly from the housing in order to minimize housing size and enable easy access to the tubing through the ports.
Preferably, the housing has an open back and the openings therein subtend a back edge of the opposing sides. The tubing capture includes an open side for enabling transverse placement of the tubing along a longitudinal axis of the tubing capture.
A first internal transverse flange is provided in the caputure having a bore therethrough of a diameter for enablign the tubing to pass therethrough and a slot in the first flange enables the tubing to be transversely urged into the bore. The slot has a width smaller than the tubing diameter and accordingly, after being pushed therepast, the tubing resides in the flange bore.
Preferably a second internal transverse flange is provided and disposed at a spaced apart distance from the first flange with a second flange having a bore therethrough of a diameter for enabling the tubing to pass therethrough and a slot in the second flange enables the tubing to be transversely urged into the second flange bore. Second flange slot also has a width smaller than a tubing diameter which prevents withdrawal of the tubing of the second flange bore without positive force being applied thereto.
The combination of flanges in a spaced apart relationship provides for a secure holding of the tubing in its relationship across the housing, and thus, prevents unwanted dislodgement of the tubing from the housing.
The tubing capture longitudinal axis may be disposed approximately at a right angle to the opposing sides or at an acute angle, for example 40xc2x0.
The present invention also includes the combination of the tubing management manifold hereinabove described in combination with the tubing.
The present invention may further include a tubing coupler disposed in one end of the tubing for joining the tubing with a second tubing with the coupler having an outside diameter smaller than the tubing outside diameter and the tubing capture includes a second internal transverse flange having a bore therethrough of a diameter enabling the coupler to pass therethrough and a slot in the second flange for enabling the coupler to be transversely urged into the second flange bore. The second flange slot in the embodiment has a width smaller than the coupler outside diameter.